Fatty acids, e.g., long-chain fatty acids, are important to human health and development. Many fatty acids are consumed as triglycerides, in which three long-chain fatty acids are bound to a glycerol molecule via ester linkages. Absorption of triglycerides by the body first requires the enzymatic action of lipases (e.g., pancreatic lipase) and bile salts, which digest triglycerides through hydrolysis, breaking them down into a monoglyceride and two free fatty acids. Digestion products consisting of a mixture of tri-, di-, and monoglycerides and free fatty acids, which, together with the other fat soluble contents of the diet (e.g., the fat soluble vitamins and cholesterol) and bile salts, form mixed micelles in the watery duodenal contents. Once broken down, the monoglycerides and free fatty acids may be absorbed by enterocytes—epithelial cells lining the small intestine—for example, in the region of the jejunum. The contents of these micelles (but not the bile salts) enter the enterocytes where they are resynthesized into triglycerides and packaged into chylomicrons, which are released into the lacteals (the capillaries of the lymph system of the intestines). Medium-chain triglycerides are absorbed directly into the bloodstream.
Patients suffering from various malabsorption impairments may be unable to adequately digest triglycerides and other forms of fat through hydrolysis, inhibiting absorption of the fatty acids required to maintain health. Further, patients may have one or more impairments that may be ameliorated by the uptake of free fatty acids, triglycerides, and/or other forms of fat. Exemplary impairments include, but are not limited to, the following: traumatic brain injury (TBI), concussion, Alzheimer's, compromised pancreatic output, acute and chronic pancreatitis, pancreatic cancer, pancreatic insufficiency, cystic fibrosis, cerebral palsy, irritable bowel syndrome, chronically abnormal epithelium, amyloidosis, celiac disease, Crohn's disease, ischemia, radiation enteritis, tropical sprue, Whipple disease, inadequate gastric mixing, rapid emptying, or both, Billroth II gastrectomy, gastrocolic fistula, gastroenterostomy, insufficient digestive agents, biliary obstruction and cholestasis, cirrhosis, chronic pancreatitis, cholestyramine-induced bile acid loss, cystic fibrosis, lactase deficiency, pancreatic cancer, pancreatic resection, sucrase-isomaltase deficiency, abnormal milieu, abnormal motility secondary to diabetes, scleroderma, hypothyroidism, or hyperthyroidism, bacterial overgrowth due to blind loops (deconjugation of bile salts), diverticula in the small intestine, Zollinger-Ellison syndrome (low duodenal pH), acutely abnormal epithelium, acute intestinal infections, alcohol, neomycin, impaired transport, abetalipoproteinemia, Addison disease, blocked lacteals due to lymphoma or tuberculosis, intrinsic factor deficiency (as in pernicious anemia), lymphangiectasia, jejunoileal bypass for obesity, or other conditions. Other patients may need or want additional dietary supplementation. Pancreatic enzyme replacement therapy (“PERT”) pills containing lipase enzymes may be consumed to improve the hydrolysis of triglycerides. Typically, PERTs are taken prior to eating and/or after eating.
However, these PERTs appear to not work or work inefficiently. Hence a need exists to overcome the deficiencies of PERTs and/or address the needs of patients unable to adequately digest triglycerides and other forms of fat.